Donald Trump's madcap presidency is now seeking to strip 20 million Americans of their health care coverage. He has instructed the Justice Department to join the lawsuit seeking to declare the Affordable Care Act unconstitutional.

He then proclaimed that Republicans would offer a far better alternative, tweeting they'll become the "Party of Great Health Care."

Only there is no plan. Mitch McConnell, the Republican Senate majority leader, wants nothing to do with trying to develop one. Confusion reigns. This grotesque misrule might be funny were it not putting millions of people at risk.

Trump has taken his animus against all things Obama to new heights in his obsessive drive to repeal or disembowel the Affordable Care Act. After the Republican Senate rejected repeal -- feeding Trump's disdain for Sen. John McCain, who cast the determining vote -- Trump's administration has sought to undermine the act administratively.

Seven million fewer people now have health care coverage since Trump was elected. Now he hopes to have the courts repeal the act. That would end the expansion of Medicaid, which covers more than 10 million low-wage workers and their families. It would repeal the requirement that insurance companies cover those with pre-existing conditions -- putting anyone who is ill now covered under the act at risk.

It would repeal the provision allowing the young to be covered under their parents plan to age 26. Once more, insurance companies would be free to enforce lifetime limits on coverage, putting the most vulnerable at risk.

Trump adds insult to this injury by proclaiming the big lie: that Republicans have or will have a plan that will cover more and be less expensive. But there is no plan. Trump aides say it will be developed in the Senate. McConnell, who rules Senate Republicans with a tight fist, says, "I look forward to seeing what the president is proposing and what he can work out with the speaker."

When asked if the two committees tasked with overseeing health care would come up with a plan, Sen. Charles Grassley responded tersely with a "no."

Scrambling to put a cover on his barefaced lie, Trump announced that Sen. Rick Scott, Republican of Florida, would join with a couple of other senators to come up with a "spectacular" plan.

This is like naming Al Capone to design the tax code. In the 1990s, Scott was the CEO of Columbia/HCA. He resigned in 1997, the same year the FBI announced an investigation of the company for massive Medicare fraud. In the end, Columbia/HCA pled guilty to systematic fraud -- featuring false billing of Medicare on a breathtaking scale. The company pled guilty to 14 corporate felonies and paid out some $1.7 billion in criminal fines and penalties in what the Justice Department called the "largest health care fraud case in U.S. history." No doubt, if Scott were to come with a plan, it would be "spectacular" for the money guys, and savage for those in need of care.

On health care, Trump's lies are dangerous to life. The U.S. is the only advanced industrial country that does not provide universal health care as a right. We are paying almost twice per capita as other countries with worse health care results. U.S. life expectancy has declined for three years, in part because of the opioid crisis, in part because of the absence of adequate health care. Meanwhile, the insurance companies and the drug companies and the private hospital complexes rake in fortunes.

What should be done is clear. The U.S. government should negotiate with drug companies to force lower prices for prescription drugs. Medicare should be strengthened and then extended to cover more people in stages. Cover those up to 30 and those 55 and over in the first stage. And then over years, perfect and extend the program to cover all. Pay for it by requiring the rich and the corporations pay their fair share of taxes. We'd end up paying less and getting better coverage.

That rational solution runs into the strongest of entrenched interests -- the drug companies and the insurance companies and their legions of lobbyists. They are prepared to spend billions to protect their profits. They buy ads to scare the hell out of people, pay for politicians, and blanket congress with lobbyists. Now they have Trump fronting for them. It will take an aroused public to overcome that resistance.

Trump believes that if you tell a big lie over and over and over again, pretty soon people will begin to believe. His political debut was the big lie about Obama's birth certificate. He's done the same with his racist rants on immigrants and the border wall. Now he plans the same big lie technique on health care: slandering what is, claiming to have a better plan when there is no plan, posturing as a champion of the people when he's defending big money interests.

The real deal is clear: the rich get a tax cut; the poor get a health care cut. The rich are living longer in splendor. The poor are dying earlier in distress. The only thing "spectacular" about the Trump health care lie is his audacity to believe that he can sell it.

You can write to the Rev. Jesse Jackson in care of this newspaper or by email at jjackson@rainbowpush.org. Follow him on Twitter @RevJJackson.

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